less invasive Maze procedure for a-fib

[bvdr]

This is from the hospital I worked at for many years and about 5 minutes from where we now live.


Doctor Develops Procedure to Help Regulate Heartbeats
Four million people have atrial fibrillation, the most common heart rhythm disorder.

Out of 700,000 strokes in the United States every year, 140,000 can be linked to atrial fibrillation. It's most common in the elderly or those with different heart defects.

Electrical impulses are what cause the heart to beat and pump blood. For some people, that system can go haywire and cause the heart's atrial chambers to fibrillate or beat irregularly. That's called atrial fibrillation.

More blood pools up in the upper chambers, which increases the risk of clots and, therefore, stroke. The options have been medical management, shock therapy to bring the heart back into rhythm, ablation therapy or surgical treatment.

A new procedure developed at FirstHealth Moore Regional Hospital called the Ex Maze procedure is a less invasive way to get the heart permanently back in rhythm.

The standard surgery, called the Cox Maze procedure, involves stopping the heart, cutting it into sections and sewing it back together. The scars redirect the electrical currents to restore normal rhythm.

Dr. Andy C. Kiser, chief of thoracic surgery at FirstHealth Moore Regional and a cardiologist, developed a new procedure called Ex Maze to accomplish the same thing as Cox Maze, but less invasively.

Using a plastic surgical model, Kiser demonstrated how his procedure uses a special heating coil encased in a long tube.

"We pass the device behind the heart, and the tether pulls right behind the heart and you can see how easily that goes through," he said.

Suction attaches the short heating coil to the surface of the heart to create a scar. The multiple scars form a pattern, or maze, all around the surface of the heart to disrupt the irregular electrical impulses.

"You direct the current of the heart in the direction that you want it to go," Kiser said.

There have been 70 such procedures done worldwide; 20 of them at FirstHealth Moore Regional Hospital. It's where many surgeons around the country will come for Ex Maze training.

"There are 3 or 4 million Americans today who don't have a good treatment for atrial fibrillation," Kiser said. "This device has really enabled us to do now what people have been trying to do for years, without having to stop the heart and cut the heart."

Until now, the procedure has only been done in conjunction with other open heart procedures. In about two months, the first "stand alone" Ex Maze procedure will be done at FirstHealth Moore Regional Hospital.

Kiser said the long-term plan is to try to do the procedure laparoscopically through small incisions, but even standard surgery for it poses a much lower risk than the current standard surgery of stopping and cutting into the heart.

Reporter: Allen Mask, M.D.
Photographer: Rick Armstrong
Web Editor: Kelly Hinchcliffe


Copyright 2007 by WRAL.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

 

[tobagotwo]

Cool beans. This is truly an advancement that can affect many in a wonderful way. Thank you for bringing this news to us, Betty.

Best wishes,

 

[geebee]

Thanks, Betty, I will watch the progress on this with interest. I have little doubt that someday my a-fib will really become an activity issue and I will have to treat it with some kind of procedure.

 

[Adrienne]

Although I had a left maze procedure when I had my mitral valve repair, and although I am in sinus rhythm, and everything is great, I still worry about the long term. This kind of eases my mind that if in the future I ever get a-fib again, they could re-do a maze without my having to have OHS.

 

[RCB]

"Show me the data!"

"Show me the data!"

This is an entirely new approach that I had not heard of. It is said to "accomplish the same thing as Cox Maze", but with 70 cases in total, how can they make that claim. Given that the Cox Maze has been the gold standard for over 20 years with lots of long term data, I would think they would publish their data so it could be peer reviewed. Another thing to remember is even the Cox Maze is not 100% successful, even with pre-selected patients. Or is this method claiming a success rate with no pre-selection?

What is unclear to me is are these statements made on the basis of a clinical research study or is it just PR?

 

[bvdr]

RCB, I'm sure there is some PR involved but here is the article from our local paper on the same subject.



New Heart Procedure Pioneered

BY TOM EMBREY: STAFF WRITER

A local heart surgeon has pioneered an improved procedure to treat a condition that affects five million Americans.
Dr. Andy Kiser and his team developed the Ex-Maze procedure to treat atrial fibrillation, a rhythm disorder that is responsible for about 15 percent of strokes worldwide.

"About 300 strokes a year in this area are due to atrial fibrillation," said Kiser, who is the chief of thoracic surgery at FirstHealth Moore Regional and a member of Pinehurst Surgical.

The condition occurs when the electrical pulses in the atria, or upper chambers of the heart, are unnatural and inconsistent. Blood pressure drops when blood flow is slowed, which can cause clots that lead to strokes.

The new Ex-Maze

procedure, which has been performed on 70 patients worldwide, is a faster, less invasive procedure than the current Cox-Maze procedure. Both rely on patterned scarring of the heart to control the path of electrical impulses and return the regular rhythm of the heart.
The Ex-Maze uses a device called the VisiTrack Ablation. The small device, which has FDA approval for use on the heart, was developed by Contact Surgical Inc. of Morrisville, N.C. It suctions to the heart and uses intense heat to scar the beating heart.

The Cox-Maze procedure, which has been the standard treatment for years, involves stopping the heart, cutting the heart into pieces and sewing it back together.

The main benefits of the new procedure are that the heart doesn't have to be stopped and that it is less invasive. During the procedure, doctors can see the heart correct to a regular rhythm.

"No one's ever been able to do it without stopping the heart," Kiser said.

Kiser, who has performed heart and lung surgery at Moore Regional since 2000, said the device needs only 90 seconds each to make each scar one of the 11 sites needed to correct the heart beat.

The new procedure takes about 40 minutes or half the time of its predecessor.

Kiser said the time will be cut further in the future when the procedure is done alone. Currently, in the United States, it is done in conjunction with other heart procedures.

Kiser said he expects the procedure to be done by itself in two to three months.

The Ex-Maze was created jointly between Kiser and other surgeons from around the world. Doctors now come to Pinehurst Surgical to observe the procedure and learn from its leading authority, Kiser.

The procedure has been performed on 30 local patients, including Paul Raisig, 74, of Harnett County. He was one of the first 10 patients at Moore Regional Hospital on whom Kiser performed the Ex-Maze procedure.

After the 30-minute procedure, Raisig also underwent a quadruple bypass.

It has been more than six months, and Raisig is free of atrial fibrillation.

"I am very pleased with everything that was done," Raisig said in a release. "Everyone was so professional. I'm sure I would not be here today if it hadn't been for them."

Kiser recently performed the first Ex-Maze procedure without opening a patient's chest. The surgery occurred in Krakow, Poland, and needed only four laparoscopic incisions. It took two hours to complete.

Kiser said the procedure is 91 percent effective after six months for patients who are younger than 85 and who have less than 65 percent arterial blockage.

Atrial fibrillation is the most common heart rhythm disorder. Common symptoms include weakness, lightheadedness, shortness of breath and chest pain. Some patients have the condition but exhibit no symptoms.

Contact Tom Embrey at 693-2473 or by e-mail at tembrey@ thepilot.com.







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